Pancho - LEY-PAT-68

Code: LEY-PAT-68
Mercy ID: V-02446-01
Encounter Date: 03/26/2007
Last: Leiva
First: Patricia
DOB: 01/20/1968
County: Gwinnett
Street: 721 Valley View Dr.
City: Stone mountain
State: GA

Zip

30087-

Cell

(678) 368-2542

Family Status

Single parent w/children

COB

Chile

Gender

Female

Housing

Doubling Up

Education Level

High school graduate

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	N/A	N/A	N/A
Father	N/A	N/A	N/A
Step Parent	N/A	N/A	N/A

Driver: YES
Relative: No
Stranger: No
Lives With: N/A
Name of School: N/A
Grade: N/A
Who Can't Pickup the Child
Authoritation Parent: No
Authoritation Child: No
DOY PERMISO: No
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: G. Landeros
Data Entry: J. Manzo